Gerontologist最新文献

{"title":"Learning lines and life lessons in The Great Lillian Hall.","authors":"Rose Capp","doi":"10.1093/geront/gnaf162","DOIUrl":"https://doi.org/10.1093/geront/gnaf162","url":null,"abstract":"","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NIH Stage Model for Behavioral Interventions in Aging: Development, Maturation, Impact, and Opportunities for Advancement.","authors":"Ana-Maria Vranceanu, Ian M Kronish, Evan Plys, Maggie Syme, Fang Yu, Joseph E Gaugler","doi":"10.1093/geront/gnaf123","DOIUrl":"10.1093/geront/gnaf123","url":null,"abstract":"<p><p>The National Institute of Health (NIH) Stage Model provides a systematic framework for advancing behavioral intervention science. It uniquely bridges basic research with the development and dissemination of interventions that are scientifically rigorous and scalable. This manuscript examines the evolution and key features of the NIH Stage Model, its incorporation of iterative and mechanism-focused methodologies, and its impact on behavioral science, particularly in aging research. We provide examples of how the model's flexibility, iterative design, focus on mechanisms of behavior change, and emphasis on scalability are significantly influencing intervention development in aging. We describe how the National Institute of Aging (NIA) Edward R. Roybal Centers for Translational Research in the Behavioral and Social Sciences of Aging have become engines of intervention development and testing according to the NIH Stage Model by funding behavioral trials across the NIH Stage Model while simultaneously supporting the development of training opportunities and scientific networks immersed in this approach. We conclude with a discussion of strategies, fully aligned and compatible with the NIH Stage Model, to further achieve the model's ultimate goal: the swift translation of interventions, including aging interventions, into clinical, community, home, or other \"real-world\" settings to benefit those that need them.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triadic Primary Care Encounters Managing Medications Among Individuals With Mild Cognitive Impairment and Dementia: Patient, Caregiver, and Clinician Perspectives.","authors":"Rachel O'Conor, Allison Pack, Andrea M Russell, Dianne Oladejo, Emily Rogalski, Darby Morhardt, Richard H Fortinsky, Lee A Lindquist, Stephen D Persell, Michael S Wolf","doi":"10.1093/geront/gnaf122","DOIUrl":"10.1093/geront/gnaf122","url":null,"abstract":"<p><strong>Background and objectives: </strong>Individuals with mild cognitive impairment (MCI) or dementia work with family caregivers and clinicians to manage multidrug regimens; however, problems with medication management are common and contribute to avoidable hospitalizations among individuals with dementia. We sought to describe the initiation of these triadic clinical encounters and medication management to identify opportunities to enhance them.</p><p><strong>Research design and methods: </strong>We conducted semi-structured qualitative interviews among individuals with MCI or dementia, their family caregivers, and primary care clinicians. Clinicians were not required to provide care for enrolled patients. Interview guides were informed by the Triadic Dementia Care Framework. Transcripts were analyzed following the Framework Method.</p><p><strong>Results: </strong>We enrolled 32 patients, 32 caregivers, and 25 clinicians. Patients, caregivers, and clinicians all prioritized patient-focused clinical encounters and noted transitions in medication management responsibilities typically occur after observing reduced patient capacity. During these transitions, clinicians noted they do not routinely provide an overview of their patients' medications to caregivers, yet caregivers expressed desire for this. Three cross-cutting themes also emerged: (a) balancing patient cognitive impairment limitations and retention of patient autonomy is important to all members of the triad; (b) historical relationship dynamics inform current clinical encounters and medication management; (c) additional time is needed to manage patients with multiple conditions and medications.</p><p><strong>Discussion and implications: </strong>Opportunities exist to utilize a multidisciplinary care team to initiate thoughtful early planning for transitions in medication management responsibilities and provide supplemental counseling and materials that reiterate the value of triadic relationships, and detail patient-medication guidance.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Perceived and Objective Financial Abilities Among Older Adults: Results From the Advanced Cognitive Training for Independent and Vital Elderly Cohort.","authors":"Ian M McDonough, Cuichan Lin, Kyle R Kraemer, Sheila R Black, Kelsey R Thomas, Lorraine T Dean, Rich N Jones, Joshua H Owens, Alden L Gross, Michael M Marsiske, Sherry L Willis","doi":"10.1093/geront/gnaf125","DOIUrl":"10.1093/geront/gnaf125","url":null,"abstract":"<p><strong>Background and objectives: </strong>Despite declines in financial ability with age and dementia, research has not explored older adults' metacognitive awareness of such declines. We investigated the relationship between subjective and objective financial abilities among older adults, and how this relationship changed over 10 years and with cognitive decline.</p><p><strong>Research design and methods: </strong>Data from older adults (N = 2,802) in the Advanced Cognitive Training for Independent and Vital Elderly study were used to assess subjective financial performance from the Minimum Data Set for Home Care and objective financial performance from the Everyday Problem Solving Test and the Observed Tasks of Daily Living. Multilevel modeling tested associations between subjective and objective performance and moderating factors.</p><p><strong>Results: </strong>In years when older adults subjectively reported fewer difficulties with their finances, they objectively performed better at financial tasks and this relationship became stronger over 10 years. This relationship was not present for older adults with a dementia diagnosis. Age and objective cognitive impairment did not moderate the relationships.</p><p><strong>Discussion and implications: </strong>Awareness of financial abilities is critical in an aging population bombarded by fraud and scams. Although older adults without dementia are metacognitively aware of their financial abilities, those diagnosed with dementia are more likely to experience financial anosognosia. These findings offer new insights for programs and early detection tools for dementia.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":"65 7","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Isolation and Loneliness in Asian American Older Adults: A Scoping Review.","authors":"Deborah Min, Lan N Ðoàn, Stella K Chong, Ankitha Kaki, Heeyoon Kim, Simona C Kwon","doi":"10.1093/geront/gnaf139","DOIUrl":"10.1093/geront/gnaf139","url":null,"abstract":"<p><strong>Background and objectives: </strong>Immigrant older adults are a particularly disadvantaged population due to structural factors including immigration and citizenship status, language and literacy barriers, and underrepresentation in health research, that increase the burden of social isolation and loneliness. This scoping review synthesizes the existing literature on social isolation and loneliness among Asian American older adults in the United States.</p><p><strong>Research design and methods: </strong>This study searched PubMed, CINAHL, and PsycInfo for relevant literature and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. 29 articles were included.</p><p><strong>Results: </strong>We summarize 4 topics that emerged on social isolation and loneliness: instruments, prevalence, associated factors, and perceptions. Most articles focused on older Chinese and Korean American adults from the Population Study of Chinese Elderly in Chicago Study and Study of Older Korean Americans, and there was a concentration of studies based in the Midwest and Northeast. One intervention was found.</p><p><strong>Discussion and implications: </strong>This review highlights significant gaps in understanding experiences of social isolation and loneliness among older Asian American adults, emphasizing the need for more inclusive research and culturally responsive interventions to promote healthy aging in this growing population.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Capacity and Functional Ability in an Aging Population: A Scoping Review.","authors":"Lisa Schwab, Stijn De Baets, Emma De Keyser, Timothy Moreels, Jade Tambeur, Patricia De Vriendt","doi":"10.1093/geront/gnaf141","DOIUrl":"10.1093/geront/gnaf141","url":null,"abstract":"<p><strong>Background and objectives: </strong>The rapidly aging global population brought increasing attention to the concepts of functional capacity (FC) and functional ability (FA), key indicators of health and well-being in older adults. Despite their importance, FC and FA are inconsistently defined, with varying dimensions and measurement approaches. This scoping review clarifies these concepts by summarizing current definitions, mapping their dimensions, identifying assessment tools, and proposing precise operational definitions to guide future research.</p><p><strong>Research design and methods: </strong>In this scoping review, a search was conducted across PubMed, Embase, and PsycInfo, supplemented by snowball searches of reference lists. Included were studies involving adults aged 60 and older, published after 2015. Definitions, dimensions, and measurement tools of FC and FA were extracted and analyzed.</p><p><strong>Results: </strong>Among 85 included studies, only 16 explicitly defined FC or FA, with significant variability. Four primary dimensions emerged: physical, mental, social, and activities of daily living (ADL). FC predominantly emphasized physical health, while FA focused on ADL independence. Measurement tools were highly diverse, with 97 instruments identified, yet limited adoption of multidimensional approaches.</p><p><strong>Discussion and implications: </strong>The findings highlight the need for standardized definitions and comprehensive, multidimensional assessments of FC and FA. Adopting the International Classification of Functioning, Disability and Health (ICF) framework offers a potential solution to align research and practice. Standardized, holistic approaches to defining and measuring FC and FA are essential to advance research, guide clinical interventions, and support aging-related policy development worldwide.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Communication for Older Adults in Residential and Community Aged Care: A Scoping Review.","authors":"Asmita V Manchha, Bridget Burton, Samantha Siyambalapitiya, Joanne M Wood, Louise Hickson, Deirdre Fetherstonhaugh, Michelle King, Sarah J Wallace","doi":"10.1093/geront/gnaf140","DOIUrl":"10.1093/geront/gnaf140","url":null,"abstract":"<p><strong>Background and objectives: </strong>Older adults often experience communication changes due to aging and an increased prevalence of conditions affecting speech, language, cognition, and sensory functions. Although individual health conditions and contextual factors (e.g., personal and environmental) are known to influence communication, limited research has examined how these factors interact. Our scoping review summarizes how health conditions, impairments, and contextual factors can interact to influence communication in residential and community aged care settings.</p><p><strong>Research design and methods: </strong>Peer-reviewed articles published 2003-2023 were identified through searches of PubMed, PsycINFO, CINAHL, Scopus, and ProQuest. Using the International Classification of Functioning, Disability and Health as a framework, we extracted information about health conditions, impairments to body structures and functions, and personal and environmental factors reported to influence communication. Data were synthesized using thematic analysis.</p><p><strong>Results: </strong>From 75 articles, we identified combinations of health conditions (e.g., dementia), impairments to body functions and structures (e.g., hearing impairment), personal (e.g., language, culture, gender), and environmental factors (e.g., relationships, health services, products/technology), reported to affect communication for older adults in aged care environments. Language and culture, and support and relationships, were both key facilitators and barriers to communication.</p><p><strong>Discussion and implications: </strong>Older adults may experience complex and diverse communication support needs that result from multiple intersecting factors. Research to date has focused on communication in residential aged care, with few studies exploring community aged care services. Our findings will inform the development of resources for identifying and supporting the communication needs of older adults who receive aged care services.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging in a Transient Place: Reflections on Place Meaning, Third Places, and Social Connection Among Displaced and Older Adults Experiencing Homelessness.","authors":"H Shellae Versey","doi":"10.1093/geront/gnaf136","DOIUrl":"10.1093/geront/gnaf136","url":null,"abstract":"<p><strong>Background and objectives: </strong>The number of people experiencing homelessness (PEH) and residential displacement is increasing. Unlike in larger cities, unhoused individuals in less dense areas may encounter difficulty accessing supports. This research examines experiences among displaced, formerly homeless, and PEH in a mid-sized town in Connecticut. Barriers and facilitators to aging-in-place are examined.</p><p><strong>Research design and methods: </strong>Recruited from a community sample, participants (N = 27) were asked to photograph their everyday lives during a 2-week period and were later interviewed about their experience using the Photovoice method. Hand-coded thematic analysis was used to interpret data.</p><p><strong>Results: </strong>Findings suggest that meaning attached to physical places and communities was important to participants' everyday experiences. Supportive communities were cited as resources for a sense of belonging. Places ranked as highly meaningful included the outdoors, the sidewalk, and third places (e.g., quasi-public spaces for socialization). Third places emerged as facilitators for social ties, establishing \"everyday life\" patterns, and creating a sense of meaning. Decisions tied to aging-in-place reflected circumstance and survival rather than desire. Themes related to social exclusion, hypervisibility, and feeling unwelcome within the town context were also discussed.</p><p><strong>Discussion and implications: </strong>Both social and material supports are critical to aging in the \"right\" place, particularly for individuals who have experienced housing precarity. Given that conditions for aging-in-place often begin in midlife and may change across contexts, meeting the needs of precariously housed adults requires a reframing of age-friendly initiatives that are inclusive and integrated with the social fabric of town and city life.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Perspectives and Experiences of Older LGBTI+ Adults About Long-Term Care: A Qualitative Systematic Review and Meta-Synthesis.","authors":"Sarah McMullen-Roach, Saravana Kumar, Maria Inacio, Carolyn Murray","doi":"10.1093/geront/gnaf048","DOIUrl":"10.1093/geront/gnaf048","url":null,"abstract":"<p><strong>Background and objectives: </strong>LGBTI+ older adults have experienced historical and systemic discrimination. Such discrimination has led to health inequities and avoidance of services. As LGBTI+ people age, they may need to access services, but information about this experience is situated in small-scale qualitative studies. As such this meta-synthesis aimed to bring together the perspectives and experiences of LGBTI+ older adults in literature about engagement with long-term care services.</p><p><strong>Research design and methods: </strong>A meta-synthesis with a meta-ethnographic approach was conducted with qualitative published and gray literature. Findings were then confirmed through community consultation conducted with LGBTI+ adults aged 50.</p><p><strong>Results: </strong>A total of 55 qualitative studies were included in the meta-synthesis. LGBTI+ older adults' perspectives and experiences were synthesized into 4 key themes: (1) We see it as being heterosexualized, (2) With no one there to guard us, (3) You have to hide 90% of yourself, and (4) I don't want a different service, I want a good service.</p><p><strong>Discussion and implications: </strong>Overarching heterosexism, experiences of discrimination, and complexities in maintaining identity all contributed to a predominately negative experience for LGBTI+ adults when engaging with long-term care. These experiences were found to align with \"minority stress\" theory. Our review found that a multilevel approach that included staff education, LGBTI+ affirmative care, and signs and symbols of inclusivity was required to reduce the impact of minority stress experienced by LGBTI+ older adults and to increase their engagement in long-term care services.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Racial Heterogeneity in \"Housing First\" Supports' Effectiveness Among Older Adults Experiencing Homelessness: Evidence From Los Angeles County.","authors":"Jared N Schachner, Steven Schmidt, Gary D Painter","doi":"10.1093/geront/gnaf050","DOIUrl":"10.1093/geront/gnaf050","url":null,"abstract":"<p><strong>Background and objectives: </strong>Just as the U.S. population is aging and racially diversifying, housing prices are spiking. These conditions could spur a homelessness crisis among older adults of color. Although researchers have examined racial stratification and age-based differences in homelessness risk, separately, few studies probe whether age and race interact to render older adults of color more vulnerable to repeated episodes of homelessness than younger adults and older White adults. Fewer still have considered whether and why \"Housing First\" interventions (e.g., rapid rehousing [RRH], permanent supportive housing [PSH]) are disproportionately effective-or ineffective-in reducing this risk for older adults of color.</p><p><strong>Research design and methods: </strong>Using individual-level data from Los Angeles County's Homelessness Management Information System, tracking Continuum of Care (CoC) services received between 2013 and 2019, we show how race and age jointly shape the risk of receiving additional CoC homelessness services after an initial CoC service. Linear probability models reveal whether PSH and RRH disproportionately reduce this risk for Black versus White older adults.</p><p><strong>Results: </strong>Our analyses indicate an age-race interaction, whereby Black adults aged 55-64 exhibit a particularly high risk of receiving additional CoC homelessness services after an initial service. PSH disproportionately reduces this risk for Black older adults.</p><p><strong>Discussion and implications: </strong>We conclude that \"Housing First\" interventions may hold particular promise for older adults of color, perhaps because these groups sort into more effective programs, on average. Future research on aging and housing should highlight heterogeneity and consider program sorting processes as a potential explanation for it.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}